This week’s #OTalk is on the topic of using standardised assessments routinely in practice and will be hosted by Dr Alison Laver-Fawcett (@alisonlaverfaw) from York St John University and Professor Diane Cox (@dianecox61) in the UK.

Here’s what Alison and Diane had to say:

In the early 1990s, as part of her PhD studies, Alison undertook a small survey of occupational therapists to explore their use of standardised and unstandardised assessments with people with neurological diagnoses. Results (n = 29 OTs) indicated that 93% of OT respondents were using informal observation of ADL, rather than standardised assessment, to assess for perceptual deficits (Laver, 1994). Back then there were a limited number of assessments developed by occupational therapists to choose from, but nearly 30 years later many occupational therapists have been involved with the development and evaluation of standardised assessments and we have evidence of their reliability, validity, sensitivity and clinical usefulness. A look through Asher’s (2014) annotated index of occupational therapy assessment tools reveals that occupational therapists now have 100s of tests to choose from, many of which have been developed by occupational therapists. Yet standardised assessments do not appear to be routinely used in all areas of occupational therapy practice. Why is that?

But nearly 20 years later, a survey of 109 Irish occupational therapists (Stapleton and McBreaty, 2009) still found that “..the consistency of [standardised assessment’ use tended to be low. The barriers to a more consistent use of standardised assessments and outcome measures included time restraints, the unsuitability of the available measures and a lack of sensitivity of the available measures to capture the effectiveness of occupational therapy’ (p55).

Whilst, a much larger study of 794 occupational therapists in the USA (Piernik-Yoder and Beck, 2012, p97) found that paediatric occupational therapists used standardised assessments more than colleagues working with adult patients. They reported: ‘With regard to administrating of standardized assessments, 393 (49.5%) respondents reported that the most common modification they make is to administer portions of standardized assessments, whereas 221 (27.9%) indicated they modify the instruction when administering standardized measures. However, 106 (13.4%) respondents specified they administer standardized measures out of the age range for which the measure is intended, and 66 (8.3%) reported they modify test materials.’

Often students returning from placement report that OTs are using an assessment that has been developed ‘in house’ in the service to fit the particular needs of the client group and the service. Or students report a standardised assessment was being using but in a modified form. Why do some OTs need to modify standardised assessments to make them useful in practice?

The College of Occupational Therapists’ (2017) in their ‘Position Statement: Occupational therapists’ use of standardized outcome measures’ encourages the use of standardised measures and states that ‘without accruing data from such sources the evidence-base to support the value of occupational therapy will fail to grow and the profession will be challenged to produce the robust information that will be essential to support future commissioning of occupational therapy services’ (p1.). So why aren’t all occupational therapists using standardised assessments routinely in practice?

Whether you are an experienced researcher, a clinician or a student please join us for this #OTalk twitter chat and share your ideas and experience.

Suggested talking points and discussion questions to focus our chat:

1. What standardised assessments do your use – why do you choose to use this / these assessments?
2. How often do you use standardised assessments in practice?
3. Do you use standardised assessments routinely/regularly in your practice? Why or why not?
4. Did you go on any training to learn to administer any of the standardised assessment
you use – what test was the training for and what did the training comprise?
5. Do you make modifications to standardised assessments? If yes, is this to the
instructions or to the materials or you use a portion of the assessment, or administer it but don’t use the scoring?
6. What are the barriers to implementing standardised assessments in practice?
7. What factors support you to use standardised assessments regularly in your
practice?

#OTalk Participants

This week’s #OTalk is hosted by the Royal College of Occupational Therapists (RCOT). The chat will be co-hosted by @TheRCOT and @DrGillianWard

As part of the development of a new RCOT vision, strategy and action plan for research and development that is fit to guide the profession’s progress and direction of travel over the next 10 years we’ve held 2 previous #OTalk chats to help inform and direct this work.

One of the key themes emerging from the R&D Review and a discussion point with several contributors was a real need to invest in building the occupational therapy research community and network, with the Royal College taking a strong lead in doing this for the profession. Currently, there is no opportunity for occupational therapy researchers to come together to develop a community of practice to share their passion for research and learn how to do it better. Our last #OTalk in September 2018 was focused on Creating a vibrant occupational therapy research community – the way forward. This led to an invited networking and think tank event held at RCOT at the beginning of April 2019 where we used a co-design approach to scope out the “feel, form and function” of an Occupational Therapy Research Network (OTRN).

The purpose of the RCOT OTRN is to support the development of a research community for networking, mentoring, information sharing and to advance research capability and capacity in the occupational therapy profession across the UK. It aims to enable occupational therapists to support each other to develop and use the research evidence base to improve services we are able to offer to the individuals, groups and communities we work with. How might it work? What would it do? We need your help to expand the discussion, and that’s what we’d like to chat with you about during the #OTalk.

We are really looking forward to hearing your thoughts and ideas, which will be a very welcome contribution to the development of the RCOT Occupational Therapy Research Network. If you get a chance ahead of the #OTalk session, it would be really helpful if you could give some thought to the type of network you’d want to join and what would help you engage with it. We’d really love to hear all of the creative ideas that you can come up with as we move into the development phase of the Occupational Therapy Research Network.

The questions forming the basis of our #OTalk discussion are:

1. How do we best support the aim of the network; “to support each other to develop and use the research evidence base to improve services we are able to offer?”. How might it work? What would it do?’

2. What would be the advantages of joining an RCOT Occupational Therapy Research Network? How can we encourage people to join?

3. Many people join networks, but how can we encourage active contribution and participation?

4. The OTRN is likely to be based around a virtual network, what should we consider when designing this?

Thank you, I look forward to chatting with you.

Gill Ward, Research and Development Manager, Royal College of Occupational Therapists.

Post Chat

Host: Gill Ward, @DrGillianWard Research and Development Manager, Royal College of Occupational Therapists.

#OTalk Participants

The OTalk. Team thought it might a good for our CPD to explore and understand UK government, legislation and acts that might impacted on our practise or could inform our knowledge and understanding better,over the year we will host a number of chat’s looking at these sort of documents,Please do suggest some for future chats.

This week Rachel Booth aka @otrach will host a chat, looking at the Equality Act 2010 which cover all areas of the UK however both Scotland and Wales has devotion rights and you can find out more about them at below links.

I’m not an expert on the equality act but here is a brief over,and below are the questions that I will be asking during the chat,followed by a reflect log to fill in after the chat that you can use as some evidence you have engaged in some CDP.

The Equality Act 2010 legally protects people from discrimination in the workplace and in wider society.

It replaced previous anti-discrimination laws with a single Act, making the law easier to understand and strengthening protection in some situations. It sets out the different ways in which it’s unlawful to treat someone.

#OTalk Participants

Hello #OTalk, this evening we thought it would a good idea to have a general chat about all things Continued Professional Development. It has been a little while since we had a general chat on this topic, but here are a few links to previous chats we have had to help get our thoughts flowing….

As a predominantly UK based chat most of those who join us will be either currently or due to register with the Health and Care Professions Council (HCPC). Whilst engaging in CPD is not all about audit it is wise to ensure that you utilise your CPD activity in a way that will support your profile if are are called for audit. Here is a link to the HCPC’s CPD resources https://www.hcpc-uk.org/cpd/

The Numbers

#OTalk Participants

This weeks #OTalk is hosted by Dr. Rob Brooks, Course Director for Occupational Therapy at Leeds Beckett University. As his blog below outlines, Rob has based this week’s chat questions on feedback from pre-registration students on their experiences of research. Join Rob on Tuesday 2nd Aril at 8pm to discuss your thoughts on this topic.

Pre-registration Research “Never again!”

We would not argue with the notion that occupational therapists need to be able to interpret research and apply this to their practice. Most occupational therapists have received some research training; indeed, the Royal College of Occupational Therapists standard for pre-registration education states that an entry level therapist should be able to:

Select and justify designs, methods and ethics appropriate to research in occupation and occupational therapy.

Disseminate research findings in a variety of appropriate ways within and beyond the profession.

Despite research being embedded in pre-registration education, engagement with research in clinical practice is variable and the number of researchers in the profession remains limited. The reasons for this are complex, I would suggest that how students experience research in pre-registration programmes is a contributing factor.

There is little published research on the experience of research by pre-registration students. When I think about what pre-registration occupational therapy students have told me about their experiences they fit into two groups. The first is the “never again!” group. This group find the process of conducting research tortuous and they often struggle to feel skilled in using research in their practice. I worry that we have alienated this group of students from research. The reasons for this can be multi-factorial – was it the way in which research was taught, was it the type of study they carried out, was it difficulty in applying the research to practice? Each student will have their own story.

The second group is those who like research (yes, there are some!). These are the students who find research stimulating and engaging. I do however have concerns about these students too. These students are skilled in research and have the potential to be the future researchers of the profession, yet when they go into graduate jobs we fail to use or nurture their research skills. Again, we can deconstruct a number or reasons – senior staff who themselves feel threatened by research knowledge, lack of opportunity/time to carry out further research, the perception that research is for senior therapists.

Question 1
What were your experiences of pre-registration research?

Question 2
Is pre-registration research actually useful?

Question 3
What could universities do differently to make research more accessible/enjoyable for pre-registration students?

Question 4
What types of research should pre-registration students be conducting?

Question 5
How can clinicians/managers use the research skills of new graduates?

Question 6
What should clinicians and academics do to talent spot potential future researchers?

#OTalk Participants

This weeks chat will be all about the The Intentional Relationship Model and host by Carolina Cordero @Colourful_OT

The Intentional Relationship Model (Taylor, 2008) outlines the process by which occupational therapists build therapeutic relationships with the people we work with. It looks at therapist-client interactions in terms of factors including the client’s interpersonal characteristics (of which there are 12 types) and the “inevitable interpersonal events” that can occur during the therapy process (of which there are 11). The model also describes six “modes” in which occupational therapists relate to and engage with their clients:

Advocating

Collaborating

Empathizing

Encouraging

Instructing

Problem-solving

The Intentional Relationship Model, as its name suggests, emphasises the need for therapeutic use of self to be something that occupational therapists engage in deliberately, giving careful consideration to which mode we use with which client and in response to which situation. This presents an interesting viewpoint on therapeutic use of self, which can often be nebulous and difficult to define, as a skill that can be broken down into a deliberate process of interpersonal reasoning. However, is it overly reductionist to view the therapeutic relationship in this way? Are there interpersonal characteristics, interpersonal events and therapeutic modes outside of those defined by the model? All questions worth asking in tonight’s #OTalk!

Tonight’s questions are:

1. Have you come across the Intentional Relationship Model (IRM) before? If not, what is your first impression of it?